Thin Air
by Oscared
Summary: Sam's not mad, he's panicking.


A/N: Was given a prompt by a friend who wanted asthmatic Sam. This is what I wrote her: a story with no asthmatic Sam. To add insult to injury, there's no plot, it's unbeta'd, and I'm pretty sure it shares several themes/scenes with two of my other fics, which was fine when I wasn't planning on posting it... But, hey, if you can look past all that, please enjoy.

***

It's one of the best feelings in the world. Thfe euphoric, post-hunt, just-escaped-death-without-a-scratch, wave of ecstasy that makes his legs tingle and his jaw slack, lips curved in a hazy smile. His baby's purring, her wheel a natural extension of his hand, her seats hugging his endorphin-lax muscles like a second skin. Heat blasts through the vents, making his frozen skin tingle as it thaws. He wants food, porn, a girl—his mind, placated by victory, yearns for the ordinary. It's an amazing feeling. It's the best feeling. And it could last forever, for as long as Dean lets it. Miles, hours, as long as the road stretches out in front of him. As long as he doesn't think, doesn't talk.

Except it becomes very clear, very early on that that's not going to happen tonight. He has barely enjoyed five minutes of bliss before his brain pulls the trigger. It's not another hunt, it's not regret or remorse, it's beside him.

It's Sam. And Sam's his duty.

Duty calls.

Five whole minutes, and Sam's still panting like some morbidly obese middle-aged man who has just run 30 seconds on the treadmill at 10 miles an hour.

Dean's pulse has long since returned to normal. He'd be willing to bet his blood pressure has already dropped to its blessedly genetically low norm—like he didn't just narrowly escape death, like he wasn't just chased three quarters of a mile by a pack of demonic dogs. He's fine. Like Sam.

Like Sam _should_ be.

Never mind that he'd been sick last week, never mind that one of the dogs had sent him careening backwards down a ditch and into a fence just a few minutes ago; those are occupational hazards, that's what they do, and they deal. Sam had been dealing just fine. Sam had barely flinched when he collided with the fence post, hadn't claimed he was remotely sick enough not to go on this hunt.

But now Sam sits in the passenger seat, head turned toward the window, body rigidly still, breathless.

"What's with you?"

On any other day Sam's lack of response would catapult Dean's irritation from the pit of his gut to his mouth, but he's relaxed and satisfied enough to control his temper.

Sam's obviously not entirely breathless, because he has managed to fog up the window to the point where Dean can't clearly see in his mirror whether there's anything in his blind spot before he pulls over. Lucky for him, they're in the middle of nowhere, surrounded by no one—besides packs of demonic dogs, apparently.

He silences the engine, turns sideways. The car clicks happily as it winds down with the uniform hum of a million crickets.

"What's going on?" he asks more emphatically this time.

The fact that Sam doesn't ask first sends that blessedly low blood pressure of Deans up a few notches. He's not mad. But he won't admit that he's scared. Maybe just unsure, not yet worried.

Sam doesn't move, doesn't make any indication that he heard Dean at all. Just huffs and puffs like the air they're breathing is not quite up to his standards.

"Hey," Dean says, snapping his fingers, trying to get Sam's attention.

Sam doesn't answer, but he does turn away from the window, tilts his head back so that he's looking directly up at the car's ceiling. That lasts an entire three breaths before he must decide that's not quite cutting it, and tries the other way, leaning forward instead. He curls into himself, practically gasping now, arms wrapping tightly around his chest.

Dean can no longer hear the clicking or the crickets; his happy muscles snap taught, ready to fight the unknown.

"Hey, hey, what's wrong? You hit somewhere? You hurt?"

Sam chokes on his efforts, leans further forward and coughs violently into his lap, seems to be struggling to decide whether to breathe or cough, and is failing miserably at doing both. The cough has been there for a week, not unfamiliar to either of them, but this? The hyperventilation, the ragged in-and-out that seems to be accomplishing nothing? That's brand spanking new.

Dean reaches out, places both hands on Sam's shoulders, curls his fingers around the collar. For some reason he wants to take off the jacket, like removing its weight will somehow let Sam breathe easier.

"Don't fucking _touch_ me!" Sam somehow growls. Except he's not mad, Dean knows. He's panicking.

Dean pulls both hands back reflexively, like Sam's on fire, his open palms hovering uncertainly in mid-air.

"Oh God, oh God," Sam gasps between two short breaths. His forehead is practically on his knees. There's the whooping intake of air and the short, sharp coughing exhale, and Dean dashes out of the car, nearly crawls over the hood to get to the other side, yanking Sam's door open.

"Here. Come here." Dean grabs Sam's sleeves, pulls him out of the car and out onto the snow-covered gravel. Sam finds his legs somewhere along the way before he crashes face-first into the ground, and leaning against the car, scrambles a few small steps toward the rear, putting space between him and his brother. He holds up a hand at the end of an outstretched arm that screams, _"Stay the hellf__ away from me."_

Dean stops just close enough that his shirt grazes the end of Sam's fingertips -- ready to pounce. Ready to do...something, anything that might help.

Sam pants and coughs and pants and coughs, grips and releases a fistful of his jeans over and over again. But he doesn't appear to be dying or passing out, or getting any closer to that point, so Dean gives him his space, even though the outstretched hand is slowly falling lower and lower. He waits and prays and hopes that this isn't one of those "you're totally screwed" situations that they tend to find themselves in on a daily basis.

After a minute or so, the rhythm of Sam's breathing changes, slows ever so slightly, isn't quite so loud. A few more minutes and Sam releases the wet/wrinkled section of jean just above his knee and pushes himself up straighter, pulls in what might be consider a real breath even though it's probably half the volume of his lung capacity.

"Holy shit," Sam finally says, his relief obvious. He crouches and leans his head back wearily against the car, coughing a few more times, but now it seems more like a test than a necessity.

Dean moves beside his brother, his knees cracking as he crouches to mimic Sam's position. "What _the hell_ was that?"

"I don't know." Sam grimaces, and it's only then that Dean realizes Sam is covered in sweat. It's literally dripping from his nose and making his hair cling to his forehead in spikes.

"You okay now? You can breathe?" It might sound obvious, but Dean wants to hear the words from Sam. Maybe it will help slow his own heartbeat.

Sam nods, coughs into his arm then wipes the sweat off his face with the sleeve of his jacket.

"I don't have any water," Dean says apologetically, not that Sam asked. His breathing is getting better with every passing second, but he looks like he's about to fall asleep. "You think you can get back in the car?"

Sam shakes his head. "Too hot."

"If I open the windows?"

Really, Dean wants to get the hell out of nowhere and into the middle of somewhere as quickly as physically possible, in case whatever this is happens again, or worse.

Sam glances up at Dean, forehead wrinkled with strain, the faint sounds of a wheeze trailing each breath. "Yeah," he nods, looks like he's stealing himself. "Okay."

***

Dean drives like a maniac until he sees street lights. Where there are street lights, there's bound to be a hospital. Plus, he's so freaking cold. Like, can't feel his hands or face, cold. He's not about to roll up the windows, though. Just in case.

Sam falls sleep almost immediately, chin to his chest, arms wrapped around himself. Dean can't hear him breathing with the sound of the wind roaring through the interior, but Sam doesn't appear to be in any kind of distress at the moment and he's definitely not as sweaty. Though driving with the windows down in sub-zero temperatures tends to negate that.

He aims for the first motel he sees, pulls right up to the office and runs in to get a room.

When the man at the desk is grabbing him a key, Dean asks, "Where's the nearest hospital?"

"Two blocks that-a way," he says with a toothy grin.

"Thanks." Dean glances over his shoulder when the clerk takes the credit card, sees that Sam is now awake, staring back at him with hooded eyes through the dirty glass window. _Not _in any respiratory distress.

Thank. God.

***

The room is much the same as all the others. Ugly, old, worn. The smell of bleach contradicts the stains on the carpet. But it's a room, in a town, with a hospital. That's all Dean needs for peace of mind right now.

"Shirt off, Sam," Dean says as soon as he has tossed his bag onto the floor at the foot of his bed. He's absolutely frozen, but won't take a shower until he has seen Sam's back.

Sam doesn't argue. He knows better. He shrugs off his jacket, throws it onto his bed. He has to pauses to cough into his elbow several times before he can remove his t-shirt. Dean doesn't fail to notice the grimace on Sam's face as he pulls the hem of his shirt up and over his head.

Sam looks at him tiredly, as if to say, _"Happy?" _

"Turn around," Dean demands. He rubs his hands together to get them warm, stepping forward to look at Sam's back. The entire left side, from his shoulder blade down to his belt, is mottled with blue-black bruises with the promise of more. "_Shit_," Dean says under his breath.

"Bad?" Sam asks, and damn, his voice is absolutely shot.

"Not good."

Dean cautiously reaches out, runs two fingers down the length of Sam's spine.

Sam hisses, eyes squeezed shut, and arches away.

"Sorry, hands are frozen," Dean apologizes.

But Sam shakes his head, swallows mid-breath. "Fuckin' hurts," he grits out.

Dean shoves his hands into his pockets, takes a steps back. "Should get an x-ray. Maybe get someone to listen to your breathing. Just to be safe."

"Car was too hot." Sam bows his head, hands on hips, continues to keep his eyes closed. "With the cough and my back..." He makes a vague gesture towards his left shoulder with his right hand.

Something's not sitting right with Dean. He feels like he's missing something. A cracked rib? Internal bleeding? Supernatural virus? What the hell would cause that kind of acute respiratory attack?

"Did you break the skin anywhere? Did one of them bite you?"

Sam huffs. "No."

"Where's your laptop?" Dean asks abruptly.

Sam cracks his eyes open, brow furrowed for a second. If he's overly concerned about what Dean's going to do with it, he's too tired to dwell on it. "Bag," he croaks, points his chin towards the bag on the chair by the door.

"I'll do some research," is all Dean offers as an explanation.

Sam curls an arm around his ribs when more coughing bursts out of him. He walks slowly towards the bathroom and away from Dean, shutting the door behind him.

Dean grabs the laptop, stops to crank up the thermostat, then drops onto the edge of the bed, listens as the fading coughing is replaced by the sound of the shower running.

***

Dean rubs a hand over his burning eyes. He has never been able to stare at a computer screen for hours on end like Sam. He blinks to focus on his watch. Four a.m.

Sam had stumbled out of the bathroom after his shower, rasping a question about pills, which Dean had anticipated. Two prescription strength painkillers already waiting beside a bottle of water on the nightstand. Sam had downed the pills, painstakingly lowered himself onto the bed and stared at the ceiling with a pinched grimace for twenty minutes before falling asleep.

Even though Sam insisted the dogs hadn't touched him, Dean did his due diligence. Still, he couldn't find anything linking the dogs to a supernatural illness that causes asthmatic symptoms. He searched everything from broken ribs to influenza to demonic dogs and every combination of the three and all he came across was a topical solution and a few concoctions of syrupy liquids that are supposed to open airways.

Dean closes the laptop, places it on the floor and reaches over the flick off the light. In the other bed, Sam groans, coughs, rolls over...or tries to roll over. He ends of gasping instead and taking several short breaths, obviously in a great deal of pain.

"You all right?"

Sam puffs, whispers, "Shit," or something like that but doesn't answer otherwise. Which means he's not okay, but Dean knows that. It's his job to ask anyway.

***

Dean's almost positive he's lying on a beach. He's baking, boiling under the sun. There are kids running around and a dog barking. Someone's calling his name, and he half expects a football to be thrown his way but then his name comes again, strangled, and now the sun's gone behind blackened clouds and it's dark as hell and hot as hell and the hell hounds are barking and someone far away yells, "Dean!"

He sits bolt upright, heart pounding in his ears, sweat pouring down his back. And it's not just from the nightmare, it's freaking _hot_ in here. He has a flash memory of cranking up the thermostat when they arrived, but it's wasn't hot hours later when he finally fell asleep...

Then the pieces of the puzzle slam into place, the dog barking? Sam, coughing.

"Dean!"

The far away voice? Also Sam's.

He spins, blinks in the darkness, sees the dark outline of Sam hunched over the end of the bed, hugging himself tightly, rocking back and forth with each rattling, wheezy breath.

"Shit." Dean throws back the sweat soaked sheet, practically falls across the distance that separates his bed from Sam's. "Again? Is it happening again?"

Instinctively, he reaches out to put a hand on Sam's back, but Sam screams voicelessly, "Don't!"

"Shit. I'm sorry. What can I do, Sam? What do you need?"

He's breathing fast and hard, but not quite gasping like he was the night before in the car. He coughs twice and moans in distress. Something Sam wouldn't do unless he was in sheer agony. And that's it. Dean can't handle it anymore. "Enough. Coat," he says senselessly, but grabs their coats and shoes and brings them over to the bed. "Put your coat on. We're going to the hospital," he demands.

"Too hot," Sam grunts out, coughing again.

"Then get outside first. C'mon," Dean says, gently grabbing Sam's right elbow and lifting up. Fortunately Sam obeys, follows Dean out to the car, falls into the Impala's seat with another agonizing grimace. "My back." He throws his head back into the seat. "My back _hurts_."

"I know. We're going to get you some help."

He remembers where the clerfk had said the hospital was, manages to get there in less than two minutes, stop signs be damned. Sam's dragging in heavy, congested breaths, but it doesn't sound like his airway's closing in on him, doesn't seem half as panicked as he was the first time.

Dean props his shoulder under Sam's right armpit and they make the 20-step walk to the ER doors together. Sam stopping at the halfway point to curse, pull away and curl into himself for a second before allowing Dean near him again so they can continue on.

The room is empty. The nurse at the triage desk looks up from her crossword like she's surprised anyone would ever have a medical emergency in the middle of the night.

"My brother needs help," Dean says before she can open her mouth.

She jumps out of her chair with such force that it rolls back and bounces off the wall behind her with a clatter. "Come right with me, honey." Her words are directed at Sam, but Sam's alternating between looking at the floor and the ceiling, eyes opening wide then squinting shut, like he's trying anything and everything to find some relief.

She leads them into the closest room, drops a clip board on the chair with instructions to fill out the form. "I'll call Dr. Murphy now," she says, disappearing into the hall before Dean can lower Sam onto the bed.

Dean has filled out what little information he can offer when the nurse returns five minutes later. "Doctor's on his way now," she assures them, collecting the clipboard and closing the thin curtain behind her.

Sam starts out propped up on the edge of the bed, but it's like he's too uncomfortable to live. "I think I need to lie down," he finally admits, trying to do it himself at first, but ends up hissing and cradling his side further, then coughing and groaning as he struggles to breathe.

Dean leaps up from the chair. "Easy, easy. Jesus, let me help you."

He grabs Sam's legs at the knees and turns them toward the foot of the bed, carefully lifting up until Sam can roll onto his back, tilting onto the right side.

This position somehow seems to work better, and Sam seems ever so slightly less distressed, though he still doesn't seem like he's getting enough air and again with all the sweating.

"Hi there. I'm Dr. Murphy," the voice announces before the doctor even pulls back the curtain. He's a short, old man with grey hair but he doesn't look like he's completely out of it or half asleep, so Dean approves. "What seems to be the problem tonight?"

"My brother can't breathe," Dean says bluntly, which sends Dr. Murphy grabbing for his stethoscope immediately.

"Okay," he says, suddenly no nonsense when he hears Sam's spongy breathing. "What's your brother's name."

"Sam," Sam rasps, then coughs, rolling harder onto his right side, protecting his left.

"Okay, Sam. Let me have a listen, okay?"

The doctor lifts Sam's t-shirt and starts on his chest, moving the stethoscope five or six times.

"Do you have any history of asthma, Sam? Any respiratory problems?"

Sam shakes his head, face still tightly pinched.

"He had the flu last week," Dean pipes up. "And took a pretty nasty fall into a fence post a few hours ago."

"And when did your symptoms start? Sit up please?"

Sam searches out his brother's gaze. Dean comes forward to help him move.

"Last night," Dean answers for him, because Sam's in far too much agony from shifting positions to respond. "After he...fell. He was hyperventilating and then he was fine. Went to bed, woke up like this."

Dr. Murphy nods, then his eyes go wide when he sees the bruising peeking out from under Sam's raised t-shirt. "Wow," he says, lifting the shirt higher and taking in all the colors. "You did quite a number on yourself."

Dean takes a look for himself and grimaces. It looks terrible, so much worse than last night, but he had expected that.

"You fell into a fence post, huh?"

Sam gives another short nod, then another crackling cough forces him to double over. The doctor makes the mistake of putting a hand on his back and Sam practically falls off the bed trying to escape the touch.

"Hey, you're all right," Dean says, though he has no idea how that could be true right now.

Sam settles eventually, his breathing still erratic but not crazy.

"You're going to need an x-ray, young man." Dr. Murphy turns, rustles through a drawer. "I'd be very surprised if a few of those ribs aren't cracked. And depending how you fell, there could be internal bruising. But I'll have to wait for the films to see."

Dean nods, Sam slumps, sweaty and exhausted and in a shitload of pain.

"Can you give him anything?"

When the doc turns around, he's holding up a small syringe. "Be right back," he says with a wink.

***

Sam's entire body deflates mere minutes after the doc shoots him up with dilaudid. His breaths become slower if not deeper, and for the first time in over eight hours, his face is relaxed. He almost falls asleep when they take the x-rays of his chest and back.

They let Dean stay by his side throughout the whole thing. Probably because they have no one big enough to haul Sam's ginormous body around.

"Yep," the doc says with an emphatic nod, pointing to hazy gray spots on the x-rays he tacks on the wall for Dean to see—because if Sam's not asleep, he might as well be. "Don't see any obvious fractures, but there's significant fluid collection along the entire backside of the left lung indicating severe bruising, and even a little bit on the right, but you said he had the flu last week?" Dean nods. "That's probably left over from that, but it's certainly not helping matters. His lung capacity has been reduced to almost half. It's no wonder he's short of breath. That combined with pain as a trigger..." He makes a circular motion with his hand. "It's a vicious cycle."

Dean rubs a hand over his face. No he hasn't been sick, or slammed into a fence post, but he's still exhausted as hell.

"I'm going to prescribe some painkillers to help for the next little while as well as 14 sessions over the next two weeks with a respiratory therapist. If he doesn't use his lungs, and get that fluid out, he could end up with some serious complications." The doc glares at Dean over his glasses.

"Uh. Yes, sir." Though he doesn't have a clue how he's going to make that happen. They're going to have to get the hell out of Dodge as soon as they're finished here to avoid being arrested for insurance fraud, they certainly don't have the money to pay for sessions elsewhere, and then there's the whole getting Sam to agree to go thing... "Thanks," Dean adds.

"Go home, get some rest, and come back tomorrow for your first session," Doctor Murphy says, handing Dean the prescription slips.

Dean pockets the scrips and then goes about the painful struggle of getting Sam's deadweight back to the motel.

***

When they got back to the motel, Dean gets Sam settled in bed, turns down the heat, goes out to pick up the drugs at a 24-hour pharmacy and picks himself up some coffee then settles in to start researching.

By the time Sam comes around, the sun's up and shining and Dean is three hours deep into memorizing RT techniques. He doesn't have any equipment, but he's surprised to find that the internet caters to the poor, criminals-on-the-run, and do-it-yourselfers like himself.

"Wha' you doin'?" Sam slurs sleepily.

"I'm studying for your homecare." He wants to sound pissed off, keep up appearances, but he is far too tired for that crap and Sam certainly doesn't deserve it.

Sam sucks in a rattling breath, rubs a hand over his eyes. "You sleep at all?"

Dean lets out a sigh of his own. "Not yet."

"Gotta sleep, Dean."

"I will."

"Haven't slept all week."

"I know you haven't, Sammy."

"Not me. You."

He's surprised by this. Surprised that Sam noticed, surprised that he didn't even notice himself. The up and down of the past week, getting Sam Advil and cough syrup and water at all hours of the night—making sure he had enough blankets, pillows, hot towels, cold cloths. He doesn't think about it. It just had to be done, and there was no one else to do it.

"How you feeling?" Dean asks, giving Sam the once over. His breathing is still shit, and the cough is pretty constant, but at least he's not turning himself inside out from the pain.

Sam stares back, eyes a little glazed, but seemingly lucid enough. "Go to bed," he demands in his painfully scratchy voice.

"You should probably take another pill if the other one's starting to wear off.."

"Dean!" Sam barks, but it's too much, and he has to turn away and cough into his arm before he can continue. "I'm serious," he says, settling for a whisper. "Get some sleep."

Dean stares back, then glances at the computer screen, looks at the diagrams he'd tried to memorize.

"I'm fine," Sam finally says. "I'm okay."

Dean looks over at his brother. Sam's eyes are wide and earnest. "Really."

"Yeah?"

"Yeah."

The overwhelming wave of exhaustion that sweeps over him then is stifling. In a good way. He can hardly convince his arms to close the laptop and push it off to the side.

"Yeah. Okay," he admits, eyes closing on their own.

He curls onto his side, facing Sam. "You wake me if you need anything, okay?" he mumbles into his pillow.

"Sure thing, bro."

Dean takes two long, deep breaths.

"And Dean?"

"Mmm?"

"Thanks."

END


End file.
